Establishment of framework for classification/categorisation and labelling of medicinal drugs and driving

The establishment of criteria for a European categorisation will have to serve most of the needs of all parties involved: health professionals, drug regulatory agencies, drug manufacturers and patients. Clear warnings and symbols are needed so patients use their medicines in the most optimal (and safest) way possible The DRUID WP4 expert group established and agreed that, according to its influence on the ability to drive, a medicine could, regarding to driving, be categorized as followed: • category 0 (no or negligible influence on fitness to drive), • category I (minor influence on fitness to drive), • category II (moderate influence on fitness to drive), • and category III (severe influence on fitness to drive). The DRUID methodology on categorisation/labelling on medicines and driving. In summary, categorisation of a medicine on driving includes several steps of evaluation after taken into account the conditions of use of the medicine on the European Union market: 1. Pharmacodynamic and pharmacokinetic data 2. Pharmacovigilance data (including prevalence of unwanted effects reported in the SmPC) 3. Experimental and epidemiological data 4. Additional data derived from the Patient Information Leaflet (PIL) and existing categorisation systems 5. Synthesis Básically conditions of use of the medicine, pharmacodynamics, pharmacokinetic data, and pharmacovigilance data (including prevalence of unwanted effects) were derived from the SmPC, while section 3 was based on a scientific literature serach. Additional data step consisted of reviewing section 4.7 of the SmPC “Effects on ability to drive and use machines” and the PIL section on “driving and using machines” as well as reviewing the previous categorisations (if available) of the medicine in Belgium, France, Spain as well as to the ICADTS list. After evaluating all the available data, a provisional category was assigned to each active substance. The provisional category was proposed and discussed during WP4 meetings where a final and definitive category was assigned and approved by all WP4 partners.Biología Celular, Histología y Farmacologí

Classification of medicinal drugs and driving : coordination and synthesis report

In total, 16 systems were found (table 9). Some of these systems are no true categorization systems: Germany directly reproduced ratings from Wolschrijn, and 5 systems have not defined categories (Greece, the Netherlands, Norway, Denmark and Finland). Only one true categorization system also included warning labels (France II). Clear relations can be seen between the different systems (figure 3). In this way, all categorizations (except Portugal) are linked to Wolschrijn. When looking at the structure of the systems, the largest evolution has been the number (and descriptions) of categories. The list by Wolschrijn included 7 categories. At first, the categories were copied (Belgium), but later on the categories were summarized and only three categories remained (Spain I). The most recent and extensive lists (France II and ICADTS) have maintained these three categories, but have added practical guidelines for patient and doctor. One list (ICADTS) introduced a calibration to BAC levels.biología Celular, Histología y Farmacologí

Drogas ilegales, alcohol y agresividad vial

El consumo de alcohol, cocaína y cannabis se asocia a comportamientos agresivos, a ser víctima de lesiones de diversas causas, y a accidentes de tráfi co, pero existen pocos estudios acerca de cómo afecta el consumo de estas sustancias la experiencia de agresividad vial. El objetivo de este estudio es analizar la bibliografía existente sobre el tema y extraer conclusiones claras respecto de su verdadero impacto. Se analizaron cinco publicaciones. Más de un tercio de los conductores tuvieron alguna experiencia de agresividad vial. Los predictores sociodemográfi cos fueron: sexo masculino, edad joven, vivir en grandes ciudades, nivel educativo alto y no vivir en pareja. Diferentes variables relacionadas con el alcohol resultaron predictoras de victimización y/o perpetración, en particular para agresiones severas y frecuentes. Considerando tres subescalas del test AUDIT, la 'dependencia' se asoció sólo a ser agresor verbal, mientras que el 'consumo' y especialmente los 'problemas' se relacionaron con casi todas las formas de agresividad vial. La frecuencia de consumo y el conducir después de haber bebido no aumentaron la agresividad vial, a menos que se condujera estando ebrio. Conducir bajo la infl uencia de cannabis se relacionó con ser perpetrador de agresividad vial. Los estimulantes (cocaína y éxtasis) se asociaron a victimización, agresión, y de manera signifi cativa a formas severas de agresividad vial. Existe una asociación entre consumo de drogas ilegales o alcohol y agresividad vial, particularmente para los ítems de perpetración. La medida en que estos hallazgos representan efectos farmacológicos, procesos psicosociales, o ambos, es un tema importante para futuras investigacionesUse of alcohol, stimulants, cocaine and cannabis is known to be associated with aggressive behavior, suffering injuries for various causes and traffi c accidents, but there are few studies on how this consumption is related to road rage experience. Our aim is to analyze the existing bibliography on this topic and draw clear conclusions as regards its real impact. Five publications were analyzed. Over one third of drivers had had a road rage experience. Sociodemographic predictors were: being male, young, living in a large city, high educational level and not living with a partner. Different variables related with alcohol were predictors for victims and for perpetrators of road rage, particularly frequent and serious aggressions. Considering three subscales of the AUDIT test, 'Dependence' was associated only with perpetrators of verbal aggression, while 'Consumption' and 'Problems' were related to almost all forms of road rage. Alcohol use frequency and drink-driving had no impact on road rage except when drivers were really drunk. Driving under the infl uence of cannabis was related with road rage perpetration. Stimulants (cocaine and ecstasy) were associated with victimization, aggression and, to a signifi cant degree, with serious road rage. There is an association between illegal drugs or alcohol consumption and road rage, particularly concerning perpetration items. The extent to which these fi ndings represent pharmacological effects, psychosocial processes, or both, is an important topic for future research

Rehabilitación integral de pacientes adultos que acuden al Servicio de Prácticas Odontológicas

Se presentan dos casos consistentes en el análisis, estudio y tratamiento de pacientes que acuden al Servicio de Prácticas Clínicas Odontológicas de la Universidad de Zaragoza. Ambos presentan edentu-lismo parcial presumiblemente secundario a periodontitis y padecen enfermedad(es) sistémicas, estando un paciente medicado, entre otros, con bifosfonatos. Para realizar su diagnóstico y plan de tratamiento, se realiza una historia clínica con su consecuente anamnesis (datos de filiación, antecedentes familiares y personales, estado de salud actual y motivo de la consulta); así como una exploración física tanto extraoral como intraoral y de estructuras adya-centes, y las pruebas complementarias necesarias. Se plantean diversas opciones terapéuticas entre las cuales los pacientes eligen la que más se ajusta a sus necesidades y recursos económicos. Finalmente, se elabora un plan de tratamiento justificado en base a la literatura y estudios científicos más relevantes y se realiza un seguimiento del mismo con el fin de rehabilitar de forma integral y multidisciplinaria su salud bucodental

Geología en la calle: un acercamiento a la geografía física de tu comunidad

Memoria ID-0214. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Polymorphisms associated with adalimumab and infliximab response in moderate-to-severe plaque psoriasis

Aims. This study evaluated the influence of pharmacogenetics in psoriatic patients treated with adalimumab and/or infliximab. Materials & methods: Prospective observational study evaluating the association of 124 polymorphisms with the response to adalimumab or infliximab (PASI75) in patients with moderate-to-severe plaque psoriasis at 3 months (n = 95) and 6 months of treatment (n = 90). Significant SNPs for univariate analysis were subjected to multivariate analysis. Results: Five SNPs were associated with PASI75 at 3 months: rs6661932 (IVL), rs2546890 (IL-12B), rs2145623 (NFKBIA), rs9304742 (ZNF816A) and rs645544 (SLC9A8). Furthermore, rs1061624 (TNFR1B) was associated with PASI75 at 6 months. Conclusion: Nevertheless, these biomarkers should be validated in large-scale studies before implementation in clinical practice

Nominalismo e ideología en el siglo XIV

Medieval logic, science of the linguistic sign, gives more relevance to the interpretative over other signs. The author of this paper proposes to demonstrate how certain terminist hypotheses when applied to propositional study enable one to clarify the ideological character of ordinary discourse as a representation of the world

Varón dependiente del alcohol

Resumen: Objetivo: Analizar el caso clínico de un varón de 38 años, dependiente del alcohol en sus vertientes de diagnóstico, consejo para el tratamiento y tratamiento del problema. Material y métodos: El caso clínico analizado corresponde al de un paciente varón, se registran las pautas de consumo de alcohol así como la problemática social, laboral, familiar y de tráfico que ese consumo le ha producido. Resultados: Se analizan los pasos dirigidos al diagnóstico sistematizado (criterios DSM-IV, cuestionarios diagnósticos de dependencia del alcohol y marcadores biológicos) y el tratamiento realizado en dicha patología, tanto farmacológico como psicosocial. Conclusiones: La dependencia del alcohol es un problema médico que se presenta frecuentemente en los servicios de urgencias y en atención primaria, patología que en muchos casos deberá ser tratada por servicios especializados, tanto en sus formas iniciales (síndrome de abstinencia) como posteriormente en tratamientos de deshabituación y rehabilitació